The dissertation is devoted to improve the diagnosis and prediction of asthma in children with recurrent episodes of wheezing at the level of the aerohematic barrier, taking into account the levels of pro-inflammatory and anti-inflammatory cytokines, total phospholipids, and Willebrand factor. 305 children were involved in the study aged 1 to 18 years with a history of recurrent episodes of bronchial obstruction. All patients were surveyed and 122 children aged 1.5 to 7 years, at different stages of the disease continued to participate in the study. Patients were dynamically monitored until the diagnosis of asthma was made. The study revealed the following anamnestic factors: pregnancy complicated by contominant broncho-pulmonary disease in the first and second trimesters of pregnancy, acute respiratory diseases during the first year of life (5 or more times a year), taking 2 or more courses of antibacterial therapy under 1 year of life, the onset of manifistation of wheezing during first year of life, family allergy history, concomitant allergist debut atopic dermatitis during the first year of life. It was found that the concentration of total phospholipids in exhaled breath condensate depended on the number of transferred episodes of wheezing. The data obtained in the study indicated the concentration of cytokines of allergic depression directly in the focus of the pathological process. The persistence of elevated concentrations of interleukin-4 and interleukin-13 in exhaled breath condensate patients with asthma after the disappearance of clinical evidence was indicative of chronic allergic inflammation in the bronchopulmonary system. Changes in Willebrand factor concentrations indicated the presence of endothelial dysfunction. The presence of the highest rates in patients with asthma indicated that Willebrand factor can be regarded as a marker of chronic inflammation of the bronchopulmonary system. The lowest indicators γ-interferon concentrations can be indirectly considered as a manifestation of allergic inflammation in children with chronic inflammation of the broncho-pulmonary system. The presence of chronic inflammation of the bronchopulmonary system in children and the relationship between the degree of violation of the integrity of the cell membranes of the epithelial layer of the lung aerohematic barrier and the number of episodes of wheezing showed the highest correlation in patients with asthma. Chronic allergic inflammation of the broncho-pulmonary system and endothelial dysfunction, which increases the permeability of vascular endothelium with subsequent accumulation of markers of inflammation directly in the pathological focus is evidenced by the presence of significant direct correlations between Willebrand factor and interleukin-4, interleukin-13. The study showed the expediency of early diagnosis of asthma formation in children with recurrent episodes of wheezing by determining the status of the function of the aerohematic barrier of the lungs. In order to optimize the diagnosis and prediction of asthma, it is recommended to use a non-invasive method of exhaled breath condensate testing with subsequent assessment of the concentration of inflammatory markers. Determination of concentrations of total phospholipids and anti-inflammatory cytokines in exhaled breath condensate has advantages in the use of this group of patients. Determining the state of the endothelial component of the pulmonary airborne barrier is recommended for early detection of the formation of chronic inflammation of the bronchopulmonary system in children with recurrent episodes of wheezing. The obtained data prove the possibility of using the concentrations of these indicators as markers of damage to the aerohematic barrier of the lungs. For early diagnosis of asthma in children with recurrent episodes of wheezing, it is recommended to use the following indicators: increased levels of total phospholipids in exhaled breath condensate ˃ 96.18 mmol / l, interleukin-4 in exhaled breath condensate ˃ 18.45 pg / ml, interleukin-13 in exhaled breath condensate ˃ 20, 17 pg / ml, Willebrand factor in blood plasma ˃ 109.7%, γ-interferon in serum < 98.62 mmol / l with a detailed clinical presentation of wheezing; and levels of total phospholipids in exhaled breath condensate ˃ 117.22 mmol / l, interleukin-4 in exhaled breath condensate ˃ 6.42 pg / ml, interleukin-13 in exhaled breath condensate ˃ 18.62 pg / ml, Willebrand factor in blood plasma ˃ 103.0%, γ-interferon in blood serum ≤ 36,22mmol / l at disappearance of clinical manifestations of wheezing.
